It’s the Relationship that Heals
“It’s the relationship that heals,” writes renowned psychiatrist and existential therapist Irvin Yalom (see p. 112 of Love’s Executioner). Every therapist worth his salt will tell you the same thing. Psychiatrist Jeffery Smith says that no school of psychotherapy has been shown to be significantly more effective than any other school, but everyone agrees that it is the quality of the therapeutic relationship that really makes a difference (see Getting the Most from Your Therapy: Become an Educated Consumer).
In The Gift of Therapy, Dr. Yalom talks about the importance of working in the “here and now,” the here and now being whatever is happening in the therapy room at the present moment, between therapist and client. Instead of talking about the client’s past or the client’s other relationships, you focus on the therapeutic relationship. The idea is that whatever interpersonal difficulties the client has will eventually be played out in his or her relationship with the therapist. In this way, the therapeutic relationship becomes a mirror for the client’s other relationships.
Dr. Smith writes that the therapeutic relationship evokes unmet needs and desires from the client’s childhood, which had been placed on hold long ago when the client was still a child. This is the basis of transference. By bringing these childlike needs and feelings to the surface and, in a sense, re-enacting the child’s relationship with its caregiver that gave rise to the unmet needs, the client is able to heal those childhood wounds.
However you look at it, it seems that transference is the driving force behind effective therapy. For me, transference motivates me to continue therapy. In the intensity of those feelings, I can sense its power — the power to heal and the power to destroy — but, ultimately, fascinating and so very attractive. It is a door that leads somewhere. The destination is uncertain, but the journey will not be boring. And a door is far better than a dead-end street.
Indifference: The Dead-End Street
My relationships with all of my previous therapists can be summed up with one word: indifference.
For a long time, I had been disillusioned with talk therapy. I believed it was only helpful for people who had no friends because it provided them with someone to talk to. In rare instances, talk therapy may prove useful for those who had serious difficulties with rational thought. I was neither of those things, and it was no wonder that talk therapy was completely ineffective for me.
I saw my first therapist approximately twelve years ago. He was a renowned cognitive-behavioral therapist. I went to him for a substance-abuse problem. He devised techniques to help me abstain from using. The main technique — the only one that I remember — was to place a quantity of money in an envelope and address it to my least favorite politician (at the time, Dianne Feinstein) as a political donation. If I were to fall off the wagon, I would have to promptly drop the envelop in a mailbox. Obviously, the fact that I would have to send money to a politician I despised was supposed to be deterrence against falling off the wagon. The problem was compliance. The whole thing seemed so absurd to me that I never even took the step of placing money in an envelope, much less addressing the envelope to Dianne Feinstein’s re-election campaign. I think I only lasted two to three sessions with that therapist. I could barely afford his hourly rate, and he could only see me on weekday afternoons, which was hugely inconvenient for me since I had a full-time job.
Soon after discontinuing therapy, I was able to wean myself off the thing I had been addicted to simply by remembering something a college professor once said about heroin addicts weaning themselves off when the price of heroin went up. I figured if heroin addicts could do it, surely I could do it too. And I was right.
For those of you who are interested, what I did was simple. I consumed the least amount of drug necessary to avoid withdrawal symptoms. I maintained the same dosage over the course of a few days. (I didn’t even measure out the drug; I just eyeballed it.) Then I would reduce the dosage by a small amount. If I started experiencing withdrawal symptoms, I would take a little bit more, just enough to make the symptoms go away. In this way, I was able to gradually reduce the dosage over time until it got to zero. The key to this strategy working — the key to any strategy working — is that you really have to want it. It won’t work if you still wanted to get high. But if you’re really done with whatever it is, this is a way to quit without having to spend thousands of dollars on residential treatment or take months off work or school, which most people can’t afford to do. But I digress.
In Getting the Most from Your Therapy, Dr. Smith refers to cognitive-behavioral therapists as kindly technicians who help clients correct erroneous ideas. That seems like an apt description, but my cognitive-behavioral therapist was more unavailable than most technicians. I have a more personal relationship with my auto mechanic than I did with that therapist.
And, as you can see, I did better on my own than with my therapist’s assistance. Why, then, would anyone waste time and money on therapy?
Ever the optimist, however, I tried therapy a second time. My second attempt at psychotherapy took place about seven years ago, and it was even worse than my first experience. I sought help after cheating on my partner of three years, and, instead of doing anything helpful, my therapist just sat there and judged me. He prescribed pointless homework assignments, such as asking my relatives about my parents’ childhood and asking my parents about my own childhood. I never did figure out the point of these assignments, and although I did put some effort into completing them, they helped me not at all. I rather disliked my therapist and his judgmental attitude, and we pretty much failed to connect in every possible way. I lasted maybe three to four sessions.
My third attempt (yes, there’s a third attempt!) barely counts. I had two sessions — one over Skype and one over the phone — with a female MFT who specialized in relationship counseling. I’m not sure why I decided to see her, except that I had attended a few of her workshops and enjoyed them. She reeled me in with a free 30–minute session, and I agreed to have more sessions with her. I opted for remote sessions because her office was an hour away without traffic, and there was always traffic. There wasn’t really anything I wanted to work on at the time, and, after two sessions, I decided that it wasn’t worth the money to continue.
That was my experience with psychotherapy. It was boring, uninspired, and deeply impersonal. Given my sampling of psychotherapists, it’s no wonder that Dr. Yalom is concerned about the future of the field.
Therapist Self-Disclosure, Authenticity, and a Real Relationship
My view of therapy changed drastically after I met Steven. Steven was not my fourth attempt at therapy because I didn’t go to him for traditional psychotherapy, which, at the time, I still had no faith in.
Steven’s openness and realness stood in stark contrast to all the other therapists’ perfunctory professionalism. When I knocked on his door, he only played the “professional therapist” role for about ten minutes. I found him somewhat intimidating in that role. He was so serious. And had he stayed in that role, I would have had a hard time connecting with him. But it wasn’t long before he took off the mask, and beneath it was a real, live human being with flesh and blood and a beating heart.
He was so real — I could feel his pain and his anger. He even let me touch his scar. The more real he was, the more real he permitted me to be. The more he revealed to me, the more comfortable I was revealing myself to him. And so it was a give and take, instead of the unidirectional relationship fostered by orthodox approaches.
The rate and intensity with which I bonded to him was something I had never before experienced. But transference, with all its power to heal, can also wound. And when the relationship is this real, you’re not only dealing with transference but counter-transference as well. Without the template of orthodoxy to guide you, where do you go?
And my little girl, who had hidden for so many years, has emerged from behind those walls that Steven dissolved. I can feel her reaching for him. Her love for him and her needs are both without bounds — the love and needs of a child. And I am afraid for her.
I have never let her out before. Obviously, she’s always exerted her influence on me subconsciously, but I have kept her hidden, safe from everyone who could hurt her. Now the walls are gone. I can rebuild them if I wanted to, but, no, she can never heal if I keep her in the dark. The covered wound festers. There is only one way, and it is forward.
